The non-surgical treatment of adenomyosis of the uterus

The non-surgical treatment of adenomyosis of the uterus is to relieve dysmenorrhea, to reduce heavy menstrual flow, and to retain or enhance fertility. The main therapeutic methods include medical therapy, uterine artery embolization, and focal ablation therapy (ultrasound-guided percutaneous microwave as well as high intensity focused ultrasound coagulation). For women who are not seeking pregnancy, the levonorgestrel-releasing intrauterine system (LNG-IUS) is the first-line medical therapy for heavy menstrual bleeding, with combined hormonal contraceptives as second choice and gonadotropin-releasing hormone agonist (GnRH-a) serving as preoperative treatment as well as postoperative treatment. For the patients with infertility, prolonged GnRH-a protocol with in vitro fertilization-embryo transfer (IVF-ET) may be the best choice. In this article, non-surgical treatment of adenomyosis of the uterus is discussed through literature review as well as author's clinical experience. Key words: Endometriosis/TH; Drug therapy; Catheter ablation; Embolization, therapeutic; Review